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Home My WebLink About15487-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z16402 Date .No~em~e[.!~,..19~? ........ THIS CERTIFIES that the bmldlng A d d i t i.on. . . Locatlon of Property ..110 Beve.rly Road, House No County Tax Map No 1000 Sechon 052 Block Southold 0 2 Lot. 1 6 Subd~v,s~on ..... Filed Map No ...... Lot No conforms substant,ally to the Apphcatton for Braiding Permit heretofore filed ~n th~s office dated · ...N.qv.. 1.0, . .1.9.8.6.. pnrsuant to wtuch Bmld,ng Permit No . 1 .5.4.8. 7 Z ...... dated . .. N.o.v: 12., . 19.8.6 .... was~ssued, and conforms to all of the reqmrements of the apphcable provm~ons of the law The occupancy for winch tlus certfficate is issued is .. .Dorm.er. a.ddz, t.i.o.n .to an exist~-ng, one family..dwelling.. .. Thecertfficatem~ssuedto . BARBARA AND FRED BRUCH (owner, Itr~ t~Xtg~tlit.)[ X of the aforesaid braiding. Suffolk County Department of Health Approval .. N ~ A ................. UNDERWRITERS CERTIFICATE NO . Pending 1 1/9/87 PLUMBERS CERTIFICATION DATED: JOHN E. WALTERS 11/6/87 Bmld~ng Inspector Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 15487 Z Permission ~s hereby granted to' ,o .~;...~...**.**;~, .~ ...~.~.~.....o~ .............. at premises located at ..... l.l..O.....~ · .~.... ,,.. .~ ..................... ......................................................... County Tax Mop No I000 Sect,on . (~'~...~- . Block ..... C)..~.. ...... Lot No...I...J~ ........... pursuont to al)pi,cation doted ..J~~ ~/.I) ......... , 19~.J~, and approved by the Budding Inspector FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUP TOWN OF'SOUT~OL~ A Th~s apphcat~on must be filled in typewriter OR ~nk, and submitted m ~ to the Building Inspec- tor w~th the following; for new buddings or new use 1, Final survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal) 3 Approval of electrical installation from Board of F~re Underwriters. 4 Commercml buddings, Industrml buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code comphance from the Architect or Engmeer responsible for the building. 5 Submit Planmng Board approval of completed site plan requirements where applicable. B For ex~stmg buildings (pnor to April 1957), Non-conforming uses, or buddings and "pre-ex~stmg" land uses 1. Accurate survey of p~operty showing all property hnes, streets, buddings and unusum natural or topographic features. 2 Sworn statement of owner or previous owner as to use, occupancy and condition of buddings, 3 Date of any housing code or safety inspection of buddings or premises, or other pertinent ~nforma- uon required to prepare a certificate. C Fees 1 Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3 Copy of certificate of occupancy $1 4.Vacant Land C.O. $5.00 $15.00 Date .9c,~°~ 22~. 1.9~7... New Budding . .~ ....... Old or Pre-ex~stmg Budding ...... Vacant Land ...... Location of Property 110 ....~.ey.e.r ~y..~.o. ~d ... House No Street Ham/et Owner or Owners of Property Fred & Barbara Bru(;~ County Tax Map No. 1000 Section , .052 ...... Block . 0.2 ...... Lot .. :~; ...... Subdlv.slon ........... Filed Map No .. Lot No Permit No. [ 5~.?...~. Date of Permit .1.1../.~ 2/.8..6Applicant ...~..o.n.H.o..~.~.~.~.o.. 9.q~.~.e.~.,..In.c.... Health Dept Approval ...................... Labor Dept. Approval .................. Underwriters Approval ........................ Planmng Board Approval ................... Request for Temporary Certificate ........... Final Certificate X Fee Subm.tted $ . 2.5...0.0. ................ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Bulldlng Permit NO. ; ~"'t.~ (please prznt) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me thls ~L day of ~c~/~3 ~ , Notary Public, ~ #, umber's signature) County Not~r~5 Publ xlc- UNDA J. COOPER Notary Public, State of NewYe~ No 4822563. Surfak County Term EXpire~ December 3~. '}9 765-1802 BUILDING DEPT. INSPECTION FOUNDATION lST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~FINAL ~Rdc~DATE OUNDATION (1st) OUNDATION (2nd) ~OUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY CODE Cdp ADDITIONAL COMMENTS: FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPART~ ENT TOWN HALL $OUTHOLD, N Y. 11971 TEL.' 765-1803 Examined /0 ~/. ~., 19 ~ g Approved }O o'aaa,,~ .~, J ~,, 19 ;~lu Permit No ! .~ '~ '/:~ Disapproved a/c (Budding Inspector) APPLICATION FOR BUILDING PERMIT NOV I Received ...... 19. Date Novembar.~,, . ,198~ INSTRUCTIONS a. This apphcat~on must be completely filled m by typewriter or ~n ~nk and submitted to the Building Inspector, w~th sets of plans, accurate plot plan to scale· Fee according to schedule. b. Plot plan showing location of lot and of buddings on premises, relatmnship to adjoining premises or pubhc stree, or areas, and gzvmg a detmled descnptmn of layout of property must be drawn on the diagram which is part of thru app! cation. c The work covered by thzs application may not be commenced before issuance of Building Permit d Upon approval of tlus apphcatzon, the Budding h]spector will issued a Buddmg Permit to the applicant Such petrol shall be kept on the premises available for mspectmn throughout the work. e. No building shall be occupied or used m whole or in part for any purpose whatever untd a Certificate of Occupanc,. shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldlng Permit pursuant to th. Bmldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, Regulabons, for the construction of buildings, additions or alterations, or for removal or demohtion, as hereto described The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and m bmldmg for necessary inspections ~.on Morizzo 8Hil. d.er~.rna.' (Signature of applicant, or name, if a corporation) F'.o. Box .78.S, $o.ut:.hold,..N.Y..~'].mT~' . (Marling address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Beneral Contraator Name ofownerofpremmes Fped and Bar'bar'a Elr'uah (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer 2 (Name and title of corporate officer) Builder's License No Plmnber's License No Electrician's License No Other Trade's License No. ~67 744 P Location of land on which proposed work will be done Beverly Road House Number Street County Tax Map No 1000 Section 0SE Subdivis~on (Name)' Southold Hamlet Block O~ Fried Map No Lot Lot 16 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existmg use and occupancy One .Family dwslli.n.g b Intended use and occupancy .. · One f~mil~ dwel2ing ,w~.~.h..docmer ad.ditig.n .......... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ I/N/SULATION] FRAMING [~/]~ FINAL REMARKS: MORIZZ[]' P O BOX 789 ,, Main Road, Southold, NY 11971 · (516) 765-5772 NOTIFY ~?ILD r ~, oEPARrMENT ,~r 765 1~O~ ~ ~5 TO m ~M FOR THE FC',J,,;~r~O~' ,WO ~FQUIRED ~ {-r~. ,. ,, .,'~ ~t {CT~t'~ MUST ~T~T~ GC;~ ~PU~ ::~ ~ ENERGY COOES NO~ ~,~ON:;{~LE FOR